stakeholder perspectives
Recently Published Documents


TOTAL DOCUMENTS

971
(FIVE YEARS 472)

H-INDEX

34
(FIVE YEARS 7)

2022 ◽  
Vol 114 ◽  
pp. 105929
Author(s):  
Sara V. Iversen ◽  
van der Velden Naomi ◽  
Ian Convery ◽  
Lois Mansfield ◽  
Claire D.S. Holt

2022 ◽  
Vol 53 ◽  
pp. 101386
Author(s):  
Manuel Ebner ◽  
Veronika Fontana ◽  
Uta Schirpke ◽  
Ulrike Tappeiner

Author(s):  
Shaffi Fazaludeen Koya ◽  
Jinbert Lordson ◽  
Salman Khan ◽  
Binod Kumar ◽  
Chitra Grace ◽  
...  

Abstract Background India has a dual burden of tuberculosis (TB) and diabetes mellitus (DM). Integrated care for TB/DM is still in the early phase in the country and can be considerably enhanced by understanding and addressing the challenges identified from stakeholders’ perspectives. This study explored the challenges and opportunities at individual, health system and policy level for integrated care of TB/DM comorbidities in India. Methods We used an outlier case study approach and conducted stakeholder interviews and focus group discussions with relevant program personnel including field staff and program managers of TB and DM control programs as well as officials of partners in Indian states, Kerala and Bihar. Results The integrated management requires strengthening the laboratory diagnosis and drug management components of the two individual programs for TB and DM. Focused training and sensitization of healthcare workers in public and private sector across all levels is essential. A district level management unit that coordinates the two vertical programs with a horizontal integration at the primary care level is the way forward. Substantial improvement in data infrastructure is essential to improve decision-making process. Conclusion Bi-directional screening and management of TB/DM comorbidities in India requires substantial investment in human resources, infrastructure, drug availability, and data infrastructure.


2022 ◽  
pp. 026101832110650
Author(s):  
Erica Wirrmann Gadsby ◽  
Gerald Wistow ◽  
Jenny Billings

Discharge to Assess (D2A) models of care have been developed to expedite the process of discharging hospital patients as soon as they are medically fit to leave, thereby improving the efficiency and effectiveness of the healthcare system. This article focuses on the implementation of a D2A model in Kent, England, which formed a case study for a European research programme of improvements in integrated care for older people. It uses the Critical Systems Heuristics framework to examine the implementation process and focuses in particular on why this improvement project proved to be so difficult to implement and why the anticipated outcomes were so elusive. The analysis highlights the value in using critical systems thinking to better evaluate integrated care initiatives, in particular by identifying more explicitly different stakeholder perspectives and power relationships within the system and its decision environment.


Author(s):  
Christine A. March ◽  
Radhika Muzumdar ◽  
Ingrid Libman

BackgroundIn response to the COVID-19 pandemic, many countries relaxed restrictions on telemedicine, allowing for a robust transition to virtual visits for routine care. In response, centers rapidly instituted and scaled telemedicine for pediatric diabetes care. Despite numerous center reports on their experience, little is known about parent perspectives on the widespread increase of telemedicine for pediatric diabetes appointments.ObjectiveTo assess parent satisfaction with virtual care for pediatric diabetes during the COVID-19 pandemic.MethodsWe conducted an online, cross-sectional survey of parents of youth with diabetes who receive care at a large, academic diabetes center regarding their perspectives on newly introduced virtual appointments. Parents were surveyed at two time points during the pandemic using a validated scale which was adapted for diabetes. We explored demographic and clinical factors which may influence parental satisfaction.ResultsOverall, parents expressed high levels of satisfaction (>90%) with functional aspects of the visit, though only approximately half (56%) felt the visit was as good as an in-person encounter. Nearly three-quarters (74%) would consider using telemedicine again in the future. Prior use of telemedicine significantly influenced parent satisfaction, suggesting that parent preferences may play a role in continued use of telemedicine in the future. There was no difference in responses across the two timepoints, suggesting high satisfaction early in the pandemic which persisted.ConclusionsIf permissive policies for telemedicine continue, diabetes centers could adopt hybrid in-person and virtual care models, while considering various stakeholder perspectives (providers and patients) and equity in access to virtual care.


Author(s):  
Lakshmi Vempati ◽  
Sabrina Woods ◽  
Scott R. Winter

Interest in advanced air mobility (AAM) and urban air mobility (UAM) operations for on-demand passenger and cargo transport continues to grow. There is ongoing research on market demand and forecast, community acceptance, privacy, and security. There is also ongoing research by NASA, FAA, academia, and industry on airspace integration, regulatory, process, and procedural challenges. Safe integration of UAM and AAM will also require different stakeholder perspectives such as air traffic controllers, manned aircraft pilots, remote pilots, UAM operators, and the community. This research aimed to assess the willingness of manned aircraft pilots to operate in UAM integrated airspace based on airspace complexity and UAM automation level. In addition, a moderated mediation analysis was conducted using trust and perceived risk as mediators and operator type as a moderating variable. The results indicated that automation level influenced pilots’ willingness to operate an aircraft in integrated airspace. A moderating effect of operation type on automation level and willingness to pilot an aircraft was also observed: professional pilots were more amenable to UAM operations with a pilot on-board compared to remotely piloted operations. Results from the study are expected to inform airspace integration challenges, processes, and procedures for UAM integrated operations.


2022 ◽  
pp. 101846
Author(s):  
Lina Zhong ◽  
Rohit Verma ◽  
Wenqi Wei ◽  
Alastair M. Morrsion ◽  
Liyu Yang

2022 ◽  
Vol 12 (1) ◽  
pp. 22
Author(s):  
Samantha Pollard ◽  
Jessica Dunne ◽  
Sarah Costa ◽  
Dean A. Regier

(1) Background: Precision oncology has the potential to improve patient health and wellbeing through targeted prevention and treatment. Owing to uncertain clinical and economic outcomes, reimbursement has been limited. The objective of this pan-Canadian qualitative study was to investigate barriers to precision oncology implementation from the perspectives of health system stakeholders. (2) Methods: We conducted 32 semi-structured interviews with health technology decision makers (n = 14) and clinicians (n = 18) experienced with precision oncology. Participants were recruited using a purposive sampling technique. Interviews were analyzed using thematic analysis. Recruitment continued until two qualitative analysts reached agreement that thematic saturation was reached. (3) Results: While cautiously optimistic about the potential for enhanced therapeutic alignment, participants identified multiple decisional challenges under conditions of evidentiary uncertainty. Decision makers voiced concern over resource requirements alongside small benefitting patient populations and limited evidence supporting patient and health system impacts. Clinicians were comparatively tolerant of evidentiary uncertainty guiding clinical decision-making practices. Clinicians applied a broader definition of patient benefit, focusing on the ability to assist patients making informed clinical decisions. (4) Conclusions: Sustainable precision oncology must balance demand with evidence demonstrating benefit. We show that clinicians and decision makers vary in their tolerance for evolving knowledge, suggesting a need to establish evidentiary standards supporting precision oncology reimbursement decisions.


Sign in / Sign up

Export Citation Format

Share Document